QUESTIONS AND ANSWERS | PATHOLOGY | CMT NTA LEVEL 4

 

1. Mention four (4) major morphological patterns of inflammation. (4 Marks)

 

Answer (4 points @ 1 mark)

i. Serious inflammation

ii. Fibrinous inflammation

iii. Suppurative or purulent inflammation

iv. Ulcers

 

2. Mention one (1) effect of chronic alcoholism on each of the following:

a) Nervous system (1 Mark)

 

Answer

i. Peripheral neuropathy

ii. Wernike- korsakoff syndrome

iii. Stroke

 

b) Gastrointestinal tract (1 Mark)

 

Answer

i. Massive bleeding from gastritis and ulcer

ii. Gastric cancer

iii. Colonic cancer

 

c) Liver (1 Mark)

 

Answer

i. Hepatitis

ii. Cirrhosis

iii. Hepatoma

 

d) Heart (1 Mark)

 

Answer

i. Dilated congestive cardiomyopathy

ii. Myocarditis

iii. Atrial fibrillation

 

e) Oral cavity (1 Mark)

 

Answer

i. Cancer

ii. Tooth decay

 

3. List six (6) Broad categories of causes of cell injury (6 Marks)

 

Answer (any 6 points @ 1 mark)

iii. Oxygen deprivation

iv. Physical agents

v. Chemical agents and drugs

vi. Infectious agents

vii. Immunological reaction

viii. Genetic derangements

ix. Nutritional imbalances

 

4. Enumerate five (5) systemic effects of chronic inflammation (5 Marks)

Answer (any 5 points@1 mark)

i. Fever

ii. Anaemia

iii. Leukocytosis

iv. Elevated erythrocyte sedimentation rate

v. Amyloidosis

 

5. a)   List two (2) types immunity (2 Marks)

 

Answer (2 points@1 mark)

i. Innate immunity

ii. Adaptive immunity

 

b)   List four (4) causes of secondary immunodeficiency (4 Marks)

Answer (any 4 points@1 markS)

x. Infections like HIV

xi. Nutritional deficiency (malnutrition)

xii. Therapies (cancer chemo, steroids)

xiii. Aging

xiv. Autoimmunity

xv. Endocrine diseases eg DM

xvi. Malignancies

 

6. 
Outline four (4) stages during pathogenesis of pneumococcal pneumonia (4 Marks)

 

Answer (4 points@1mark)

i. Congestion

ii. Red hepatization

iii. Gray hepatization

iv. Resolution

 

7. List five (5) outdoor air pollutants (5 Marks)

 

Answer (any 5 points@1 mark)

i. Ozone

ii. Nitric oxide

iii. Sulfuric dioxide

iv. Acid aerosols

v. Carbon monoxide

vi. Particulates

 

8. Outline five (5) clinically useful serum tumour markers (5 Marks)

 

Answer (5 points@1 mark)

i. Human chorionic Gonadotrophin (HCG)

ii. Alpha feto-protein ( AFP )

iii. Carcino – embryonic Antigen (CEA)

iv. Prostate acid phasphates

v. Paraproteins ( Monoclonal immunoglobulins)

vi. calcitonin

 

 


SECTION E: GUIDED EESSAY QUESTION 30 MARKS

Instructions

· This section consists of three (3) questions which are supposed to be answered in a narrative way

· Write your answer on the blank pages of this question paper; each question should start on a new page

· There will be a penalty of three (3) marks from score attained in this section if question(s) is/are not answered in essay form

 

1. Describe the major differences between benign and malignant neoplasms (10 Marks)

Answer

Definition (2 marks)

Neoplasm is an abnormal mass of tissue.  The growth which exceeds, and is uncoordinated with that of the normal tissue and persists in the same excessive manner after cessation of the stimuli which evoked the change

 

Differences (4 points @ 2 marks)  

· Degree of differentiation

Benign – well differentiated

Malignant – range from well differentiated poorly differentiated to undifferentiated.

 

· Rate of growth

Malignant tumor grows more rapidly than do benign tumor.

 

· Local invasion

Benign most do not have capacity to infiltrate or invade as do malignant tumor.

 

· Metastasis

With few exceptions malignant tumors can metastasize

Benign – do not metastasize.

 

 

 

 

 

 

 

 

 

 

 

2. Describe the effects of cigarette smoking to human health. (10 Marks)

Answer

Effects (5 point@2marks) 

· Chronic respiratory diseases (OPD) etc.

Chronic bronchitis

Emphysema

· Cancers – of respiratory, pancreases, lip pharynx, GIT, liver etc.

· Cardiovascular diseases

Increase risk of atherosclerosis

Myocardial infarction

Hypertension

· Gastrointestinal tract – increase risk of peptic ulcer disease.

· Maternal smoking

Abortion

Low birth weight

Congenital anomalies

· CNS ; Stroke

· Reduced fertility

 

3. Describe the mechanism and different types of hypersensitivity reaction (10 Marks)

 

Answer

 

Definition (2 marks)

Hypersensitivity is the pathological reaction of the immune system which occur during the     repeated exposure to the same antigen in a previously sensitized individual.

 

Types (4 points each 2 marks)

· Type I hypersensitivity

Production of lg E antibody – immediate release of vasoactive amines and other mediators, later recruitment of inflammatory cells

 

· Type II hyper sensitivity (Antibody-mediated)

Production of antibodies – bind to the antigen and phagocytosis follows.

 

· Types III hypersensitivity (immune – complex)

Deposition of antibody antigen complex to the tissue evokes the immune reaction.

 

· Type IV hypersensitivity (cell – mediated)

Activated lymphocytes – release chemicals which evokes further inflammation


1.
A. Define emphysema (1Marks)
It is the presence of air into the body tissue.
B. Mention four major classes of lung emphysema (4Marks)
Panacinar
Centriacinar
Distal acinar
Irregular acinar
2. Patient came to your hospital with chief complain of difficulty in breathing,
coughing blood sputum and patient is severe wasted and you did chest x ray
which revealed there is pleural effusion and you did taping clear blood fluid
came out.
A. What is the diagnosis LUNG CANCER (1 mark)
B. Mention the name for the complication which will arise to the lung if
not treated ATELECTASIS
C. Mention three types of named complication ii (3 marks)
Resorption atelectasis
Contraction atelectasis
Compression atelectasis
63. Mention five roles of apoptosis
Apoptosis eliminates cells that are genetically altered or
injured
defense mechanism against viruses
prevent matured lymphocytes against self-cell
organogenesis.
Death of cells that have served their useful purpose.
4. John, a civil worker sustained left lower limb injury after fallen from height
one examination you found swollen posterior part of the thigh with severe
pain, what are five chemical mediator likely to be found on the swollen part
of the limb? (5Marks)
serotonin
kinin
complement protein
prostaglandin
coagulated protein
5. During ward round at surgical ward one of the clinician explained pain and
swelling as the reason for admission to many patient with malignancy tumor,
mention five features of malignant tumor
Distant metastasis
Grow faster
Poor margin
Poorly differentiated
Not encapsulated
6. In clinical meeting one of the physician explained role of tumor markers in
diagnosing cancers of different body organs,
A. What do you understand the term tumor marker (1Mark)
Tumor marker is a substance, usually detected in the
serum, whose concentration can be related to the
presence of tumor.
7B. Mention four tumor markers (4Marks)
Human Chorionic Gonadotrophin (HCG) for
Chorionic carcinoma
Alpha feto-protein (AFP) for Hepatoma.
Carcino-embyonic antigen (CEA) for Colo-rectal
cancer.
Prostatic acid phosphatase for prostatic cancer
7. A 67 years old male come to your clinic with complains of progressive
generalized body swelling for more than 3 months due to chronic illness,
A. What is the pathological name of that body swelling (1Mark)
OEDEMA
B. Mention four causes of the swelling above (4Marks)
Increasing hydrostatic pressure
Reducing oncotic pressure
Salt and water retention
Lymphatic system blockage
8. Mention five fate of inflammation (4marks)
progression
discharging in chronic osteomylitis
pathological fracture in osteomylitis
septicaemia
scarring
Death
resolution
8SECTION E : 30 marks
1. Discuss chronic obstructive pulmonary diseases based on definition,
diseases, and risk factors (10marks)
It used to describe progressive lung diseases including bronchitis,
asthma, bronchiectasis and atelectasis.
Risk factors including
Most cases of COPD are caused by inhaling pollutants, cigar and
second hand smoke.
Fumes, chemicals and dust found in many work environments are
contributing factors for many individuals who develop COPD.
Genetic can also play a role in an individual development of
COPD even if individual has never smoked or has ever been
exposed to strong lung irritants in the work place.
2. During pathology session tutor explained about three types of tissue in the
body, with examples explains three types of tissues.(10marks)
Continuously Dividing Tissues
Cells of these tissues (also known as labile tissues) are continuously
being lost and replaced by maturation from stem cells and by
proliferation of mature cells.
Labile cells include hematopoietic cells in the bone marrow and
the majority of surface epithelia,
Stable Tissues
Cells of these tissues are quiescent (in the G0 stage of the cell
cycle) and have only minimal replicative activity in their normal
state.
These cells are capable of proliferating in response to injury or
loss of tissue mass.
Stable cells constitute the parenchyma of most solid tissues, such
as liver, kidney, and pancreas.
9Permanent Tissues
The cells of these tissues are considered to be terminally
differentiated and no proliferative in postnatal life.
The majority of neurons and cardiac muscle cells belong to this
category.
3. Discuss extracellular matrix based on definition, components and its clinical
importance (10marks)
The ECM is a dynamic, constantly remodeling macromolecular
complex synthesized locally, which assembles into a network that
surrounds cells. It constitutes a significant proportion of any
tissue.
Components
Fibrous structural proteins such as collagens and elastins, which
confer tensile strength and recoil;
Water-hydrated gels such as proteoglycans and hyaluronan ,
which permit resilience and lubrication.
Adhesive glycoproteins that connect the matrix elements to one
another and to cells.

Clinical importance

Mechanical support for cell anchorage, cell migration, and
maintenance of cell polarity.
Control of cell growth
Maintenance of cell differentiation.
Scaffolding for tissue renewal.
Establishment of tissue microenvironments.
Storage and presentation of regulatory molecules.

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